基于创新扩散理论的广西农村校外青少年预防艾滋病互联网+健康教育干预研究

Guangxi is an area of high incidence of AIDS in China, and younger age is an important tendency of AIDS epidemic. Due to leaving early to school and lacking of supervision and formal education, the out-of-school adolescents especially who live in rural areas is a high-risk population of AIDS infection and transmission. In current, the health education of AIDS prevention for the out-of-school adolescents in rural is in a blank state. There was less research in health education of the out-of-school adolescents in rural areas. . The health education studies before almost were based on the theory applied to individual-level and the traditional health education methods cannot apply to the out-of-school adolescents which is one of special adolescents group that not only be different from the students in school but also the normal floating population. The theory of diffusion of Innovation is defined from the group-level analysis, explained the spread and adoption of innovation process. As one of the innovation, the health information is different from other technology and policy, and it is not yet clear that the characters and the function route of influencing factors of the diffusion. ‘Internet+’ health education will be a new trend of health education in era of mobile Internet. . This study, which is based on the theory of diffusion of Innovation, is to design a health education application (APP) of AIDS prevention and establish its theoretical model of the diffusion of Innovation. It is to use the sampling survey by Respondent-driven Sampling (RDS) to select the out-of-school adolescents in rural for health education intervention through APP. Besides, the effect will be evaluated for health education intervention by questionnaires, using the structural equation model (SEM) to inspect and correct the theoretical model of the diffusion of innovation of the health education APP, and revealing the interaction and the function route between various factors. What’s more, the study is to explore the new mode that is ‘Internet+’ health education way of AIDS prevention for the out-of-school adolescents, and to provide a empirical and theoretical basis for the application of the theory of diffusion of innovation in health education.

广西是我国艾滋病的高发区，低龄化是艾滋病流行的一个重要趋势，农村校外青少年由于过早离开学校、缺乏监管和正规教育，是艾滋病感染和传播的高危人群。目前针对农村校外青少年艾滋病预防的健康教育研究较少。既往健康教育研究主要基于应用于个体水平的理论，创新扩散理论是从群体层面分析和解释创新被传播和采纳过程的理论，而健康信息作为一种创新，其扩散的特点及影响因素的作用路径尚不明确。互联网+健康教育将引领健康教育的新趋势。本研究基于创新扩散理论，研发预防艾滋病的健康教育APP软件，并建立其创新扩散理论模型；采用同伴驱动抽样方法选取农村校外青少年，并通过APP进行健康教育干预；通过问卷调查对健康教育效果进行评价，同时利用结构方程模型对健康教育APP的创新扩散理论模型进行检验、修正，揭示模型中各因素之间的相互作用与作用路径，探索适合农村校外青少年艾滋病预防的新模式，并为创新扩散理论在健康教育中的应用提供实证依据

广西是我国艾滋病的高发区，农村校外青少年是艾滋病感染和传播的高危人群。目前针对农村校外青少年预防艾滋病的健康教育基本处于空白状态。既往艾滋病健康教育研究主要基于应用于个体水平的相关理论，且传统健康教育方法无法更好的适用校外青少年。创新扩散理论是从群体层面分析和解释创新被传播和采纳过程的理论，互联网+健康教育将成为互联网时代健康教育的新趋势。本研究采用同伴驱动抽样方法选取农村校外青少年，在分析校外青少年的基本特征和对艾滋病认知现状的基础上，充分利用互联网平台，基于创新扩散理论，对其进行健康教育；最后对互联网+健康教育效果进行评价，同时探索互联网+健康教育干预相关因素间的作用路径和关系，建立校外青少年互联网+健康教育干预的创新扩散模型。结果显示，校外青少年和在校青少年的社会人口学特征存在较大的差异，校外青少年对艾滋病的各项认知评分均低于60分。校外青少年发生性行为的比例较高(30.61%)，其中超过1/4的性行为对象是商业性伴，且近20%的是同性性行为，而且在性行为时未使用安全套的比例较高（74.60%），校外青少年无论在认知还是行为方面均差于在校青少年。实施互联网+健康教育后，青少年在艾滋病认知方面有明显的提高。特别是校外青少年提高的幅度远高于在校青少年。互联网+健康教育干预对性行为的发生和商业性行为的干预效果较好，但是，在安全套的使用方面效果并不明显。认知、态度对行为意向的净效应分别为0.35、0.22，态度在认知与行为意向之间发挥着中介作用，效应大小为0.14。青少年互联网+健康教育干预的创新扩散呈现S型曲线，与创新扩散理论相吻合。校外青少年初期对创新接受或采纳的比较少，经过一段时间后，接受或采纳创新的校外青少年迅速增加。互联网+健康教育干预模式更适合校外青少年且健康教育干预效果较好，而且创新先驱者的选取在校外青少年互联网+健康教育干预中十分重要。

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